DESIGNING SELF-CARE TECHNOLOGY TO ENHANCE PATIENTS’ PREHABILITATION ENGAGEMENT

Restricted (Penn State Only)
Author:
Zhu, Haining
Graduate Program:
Informatics
Degree:
Doctor of Philosophy
Document Type:
Dissertation
Date of Defense:
June 05, 2019
Committee Members:
  • John M Carroll, Dissertation Advisor
  • John M Carroll, Committee Chair
  • Mary Beth Rosson, Committee Member
  • Saeed M Abdullah, Committee Member
  • Aleksandra B Slavkovic, Outside Member
Keywords:
  • Healthcare
  • Prehabilitation
  • Rehabilitation
  • Social Support
  • HCI
  • Collaboration
  • Workflow
  • Facial Paralysis
  • Surgical Care
  • User-centered Design
  • Chronic Condition
Abstract:
Millions of surgeries are performed in the US annually, and with lifespans growing longer, these procedures are becoming more numerous with every passing year. Traditional rehabilitative interventions are struggling to meet current demands, and researchers have turned to pre-operative interventions, or prehabilitation, to improve patient functions prior to surgeries. However, current prehabilitation research is predominantly conducted from a Health Sciences approach and geared toward understanding and determining effective treatment plans. This approach fails to address problems regarding engagement, accessibility, and scalability. I therefore conduct a series of studies exploring prehabilitation from a Human-Computer Interaction lens to complement these existing studies. HCI is uniquely poised to address these gaps because its techniques can offer comprehension of stakeholders through user-centered studies and design insights regarding targeted tools. In this dissertation, I explored stakeholder needs, and challenges via mixed-methods approaches. I describe a case study in which I examined the interactions of a complex facial paralysis treatment team that utilizes prehabilitation in its practices; this study results in a detailed clinical workflow model and identifies the key patient challenge of losing motivation to adhere to exercises because of an inability to perceive gradual recovery progress. By synthesizing the results of these studies with self-monitoring and social support theories, I present an understanding of prehabilitation practices and design spaces and identify design opportunities for targeted and effective prehabilitation self-care technologies. This understanding informed the design of MyFace, a mobile self-care technology intended to aid facial paralysis patients in their prehabilitation. MyFace holistically tracks patients’ recoveries and helps them become more aware of gradual improvements. It specifically tracks facial exercise durations and frequencies, user feelings, and visual media over time to allow for assessment of changes; in addition, the system leverages social support which can contribute to their motivation to sustain self-care contributions. The system shows great promise in promoting users’ self-awareness, self-reflection, motivation, and engagement and adherence. This dissertation not only provides support for the novel idea of using visual media feedback to increase prehabilitation motivation and adherence in facial paralysis contexts, it provides support for the adoption of an HCI lens in prehabilitation research to better support high quality prehabilitation and prehabilitation technologies.